Food and Society

The relationship between food and society require special attention. Food come first, no food no life, this is a fact, and nothing can be possible with out food. Society is a group of people related to each other through perseverance relations such as status, roles and social network. In pre-industrial societies, food production is carried out through the use of human and animal labour which is the main economic activities. Industrial revolution in 19th century brought the incredible changes.The most important invention was a railway which has put an unbelievable impact on different societies. The railway makes feasible the movement of people and transports the goods from one city to another even from country to country. This makes possible the food that had previously never been seen or heard of became available to most of the people. Most of the societies rely on the food transport and production, then those societies can be divided according to their level of technology and their method of production.The study of food and society is gradually increasing which is recognised to be one that can make a significant contribution to our understanding of the context with in which the production and consumption of commercial food and beverages takes place. The provision of food and beverages forms a part of the activities of the hospitality industry. However the hospitality industry subject area, there is just a small number of texts that cover the field. As an alternative of texts and resources that can contribute relevant theoretical frameworks to support the study of food and society are to be found in a number of fields of study.

2 Random Speeches Bob Marley and Beauty (Ideas)

Speech September 27, 2012 Bob Marley the Rastafarian I. Nesta Robert Bob Marley was born February of 1945. Bob Marley was born in Jamaica. You might know him as a singer, song writer, a rhythm guitarist, and lead singer of the Wailer’s. He stayed with the group through most of his life. Bob is the go to guy for spreading Jamaican music and the Rastafarian movement. Some of his most popular songs are: I Shot the Sheriff, No Women No Cry and Jamming to name a few, I listen to some of his music, which for me is inspirational. Gives me something to think about, what was going on in his mind mentally and the thoughts about war, peace and love.II. One of my favorite quotes from Bob is â€Å"I don’t have prejudice against white people because then I would have prejudice against myself. My father is white my mother is black. I’m not on the black men side or the white men, I’m God’s side. Bob Marley was raised Catholic, but became a devoted Rastafarian and started growing dreads, which is very important to them, it’s like the anatine tuning meaning you’re into the universe. Rastas are also vegetarian. Bob was a jiglo with eleven kids, some you might know like Damien Marley and Ziggy Marley. III.Rastafarians also were avid pot heads which is a Rastafarian belief were ganja or that kush is a holy sacrament. The difference between Rastas and non Rastas are that they smoke for religious and medicinal purposes. Another quote I like is â€Å"why do government people want the herb to be illegal, why something that makes people so happy, so relax so illegal? Some people smoke weed because you rebel makes you question what is and what isn’t. Exercise your mind frees your mind in a society that tries to involve it’s self in everyday life telling you what is right and wrong! † IV.In July 1977 Bob found out that out that he had cancer all throughout his body, he even had spots his brain the size of quarters that the doctor didn’t understand how he last so long without any medication or medicine assistance. He was buried near his birth place; his last words were to his son â€Å"mommy can’t buy life†! I know that for me inner beauty supposed to shine through to reveal your outer beauty; and it’s taken me awhile for me to truly understand why men and women choose physical beauty over inner beauty. Physical beauty and inner beauty can be similar and dissimilar.Inner beauty are the actions we take, whether it’s giving up a smile to a stranger, eating the right foods, wearing clothes that shows our physique, or using the right hair tools: such as curling irons, flat iron, and gel. These are things we do to take care of ourselves, and they add up to make us the unique person that we and you are! Physical and inner beauty can be similar or dissimilar: they both attract people. People in general are attracted to both physical and inner beauty. I may be drawn to M orris Chestnut’s appearance; while my big sister will love his personality. Physical and inner beauty are both equally important though.Let’s take for example: Beyonce, who many young girls and women admire for her unique sense of style (myself included). I’ve never met her in person, but it seems to me that she has this balance of inner and outer beauty. As the face of L'Oreal, a brand known for their quality cosmetics: hair and nail colors; we have seen Beyonce’s alter ego Sasha Fierce! She’s a bad Bitch! She also appears to be very comfortable in her own skin either portraying Etta James in Cadillac Records or Deena Jones in Dream Girls. When I watch Beyonce being interviewed, she seems very genuine, candid, and confident when sharing bits and pieces about her life.I sense that she pay close attention to details: hair, make-up, perfume and the clothes she wears. Finding balance between inner and outer beauty doesn’t just happen overnight. It’ll take some inner soul searching and discovering of our own uniqueness: hat beauty could be in the form of how we dress or the way we shine! Most importantly it’s the way we feel about ourselves, and having the awareness that beauty consists of both the inner and outer, we are the first step to becoming more authentic and the real person that we were meant to be, Beautiful!

Questions on Mutiple Topics Essay Example | Topics and Well Written Essays - 3500 words

Questions on Mutiple Topics - Essay Example Portfolio matrices have become popular tools due to the various advantages that companies derive from them. First, portfolio matrices are very flexible as they can be applied to products, brands, and strategic business units. It should be noted that the use of portfolio analysis is not limited to products or brands only. Portfolio matrices can be used to ascertain the competitiveness and strengths of brands, product lines, and profit centers. Portfolio matrices are often used as cash management tools as they provide managers an easy and graphical way to assess how much cash the business will be using or generating in putting its products or services in the market. It also tells managers which products or units to invest in according to their attractiveness and competitiveness. The use of portfolio analysis is essentially to help managers focus on their core and profitable businesses. Portfolio matrices are also commonly used among business organizations because of their relative simplicity. The core ideas behind each portfolio matrix can be easily grasped and understood by any manager. Therefore, portfolio matrices are often easier to understand than other business tools. However, the use of portfolio matrices in crafting business strategies also presents some drawbacks. For one, portfolio matrices are often seen as having a â€Å"too simplistic† view of the world that it overlooked other important qualitative factors. For example, the Boston Consulting Group (BCG) matrix considers the relationship between market attractiveness and market growth. It should be noted however, that high growth markets are not necessarily attractive and low growth markets are not necessarily unattractive (Growth-Share Matrix, 2006). Another pitfall of portfolio matrices is that it does not consider the interaction of business units or the entities being considered. It should be noted that in portfolio matrix analyses, products are considered in isolation

Chemistry Coursework Example | Topics and Well Written Essays - 250 words

Chemistry - Coursework Example Differences; Enzymes are organic, containing protein sub-groups. As such they are high molecular weight compounds. Inorganic catalysts are often low molecular weight. Inorganic catalysts are more resilient to changes in temperatures. An example is Pt/Rh catalysts used at high temperatures. This is compared to organic catalysts that denature past a certain temperature (mostly 40 degrees Celsius). Enzymes are also manufactured by biological systems, and as such most are highly specific to the reactions and substrates they require for such. Inorganic catalysts are sometimes ambiguous. They catalyse numerous reactions as long as the conditions are right. For example Platinum, Pt is a catalyst for a wide range of industrial processes. Lock and key model- this model was proposed by Emil fischer. It states that an enzyme is like a lock, while a substrate is like a key. As such, an enzyme can only be bound by a specific type of substrate (Spencer Seager, 2013) and this means that for any given enzyme, the substrate has to be specific or highly similar to the substrate for the reaction to occur. This model/ theory shows the enzyme as conformationally rigid and able to only act on substrates that are an exact fit. (Timberlake, 2014) Koshland’s induced fit theory- this theory states that an enzyme is not a rigid structure. As a substrate binds, it leads to conformational change that enhances the enzymes ability to carry out its catalytic function. In some cases the enzymes active site is remoulded completely and the charge of the enzyme also modified as it binds to its substrate. (Spencer Seager, 2013) After catalysis has been carried out, the enzyme resumes its original shape. Q3 You are an investigator and your research group has just isolated two novel enzymes A and B that are both secreted into the small intestine of the domestic pig Sus scrofa. You would like to have these enzymes characterised. Therefore you have asked your project student

Managing Performance Examine why performance management is a necessary Essay

Managing Performance Examine why performance management is a necessary but often difficult process in organisations - Essay Example That is, as part of performance management, the organisation has to keep the mental as well as physical state of the employees in an optimum state. Only if the employees’ are physically fit and importantly mentally motivated, they can optimally contribute their skill, knowledge and hard work for the success of the organisation. So, through performance management, the employees can be optimally motivated to provide optimal contribution. As part of performance management, the organisation, management, leaders and managers has to implement certain steps or strategies. These performance management strategies will surely elevate the employees’ motivation and make them productive. However, while implementing these strategies, there will certain pitfalls or problematic issues, which could hamper the strategies from reaching logical conclusion. That is, these issues will cause certain problems, which could make these strategies unsuccessful. So, although performance management strategies will lead to many positives for the organisation, there will be some difficulties in aptly implementing it, and this paper will examine this issue by focusing on the performance management strategies in each aspect of organisational functioning. Performance management refers to commitment by managers to achieve highest performance levels. Managers should take responsibilities to eliminate road blocks to success by providing sufficient resources and be careful in employee selection process as well as being ready to provide adequate rewards valued by employees (Cascio, 1996). The activities conducted by managers before, during and after interviews of performance feedback entail roles before interviews including communication with employees on their performance by coaching them, giving feedback and communicating performance efficiency. During interviews, the manager should avoid judging individuality of the employees and ponder on performance in order not to discourage

Nursing Practice. Roy Adaptation Model Research Paper

Nursing Practice. Roy Adaptation Model - Research Paper Example Adaptation is defined by RAM as the process and outcome, in which thinking and feeling of persons utilize conscious awareness to fashion integration between human perception and their environment. The paper explores the efficacy and application of Roy Adaptation Mode within the nursing practice. Roy Adaptation Model # 1a Summary of the Theory Roy’s adaptation model was advanced by Sr. Callista Roy and sums up as one of the broadly applied nursing models in nursing practice, education and research. The theory approaches nursing as the science that broadens adaptive abilities and promotes individual and environmental alteration. According to RAM, nursing goals pursue promotion of adaptation for persons and groups in four adaptive modes that contribute in the promotion of health, quality of life and dying with dignity (Clarke, Barone, Hanna & Senesac, 2011). Adaptation in this case is manifested by four interconnected modes of behavior: physiological, self-concept, role function and interdependence modes. RAM promotes nurse’s capabilities to enhance a person’s interaction with the environment to avail of an effective adaptation. According to RAM, an individual is described as an adaptive system capable of responding to diverse internal and external environment stimuli whether positively or negatively (Clarke, Barone, Hanna & Senesac, 2011). ... Roy adaptation model (RAM) is useful as it guides nursing practice and avails scientific knowledge for practice. The model has been essential in organizing nursing education, clinical assessment and intervention (Clarke, Barone, Hanna & Senesac, 2011). RAM comes out as an applicable, flexible and valuable model that can be employed in diverse aspects of nursing research. #1c Limitations of the Theory RAM has inspired the development of various middle range nursing theories. RAM arrangement of concepts is logical; however, the empirical precision of some terms and concepts is inadequate to mirror nursing disciplines. This may decrease the clarity of the model when employed in any specialized area of practice. The theory manifests explicit assumptions. These include the individual is mainly a bio-psycho-social being; the individual is in a continuous interaction with a changing environment; in order to cope with the changing world, individual usually employ both innate and acquired mec hanisms that are characteristically biological, psychological and social; health and illness are un avoidable dimensions in an individual’s life and in order to react positively to environmental changes, individuals must adapt (Clarke, Barone, Hanna & Senesac, 2011). # 2a Articles from the Nursing Literature that discusses RAM The application of RAM differs from one design to another depending on the predicted goals and the form of adaptation level required for monitoring. In the outlined studies, RAM plays a critical role in shaping research direction and the adaptation of participants. Huang, Carter & Guo (2004) study sought to estimate daytime sleepiness and measure factors unsettling the adaptation of sleep loss during the early postpartum

The Role Of The Lend-Lease Program In Allied Victory During WWII Essay

The Role Of The Lend-Lease Program In Allied Victory During WWII - Essay Example That fiction of neutrality became threatened by a long string of Nazi victories in Europe. The administration of President Franklin Roosevelt soon began to look for options give aid to Britain while remaining out of the war in a strictly military sense. 'If your neighbor's house is on fire, should you not help to extinguish it?' Britain's house was ablaze, and it is doubtful the total collapse of Britain and democratic states in Western Europe would not have posed a threat to the United States at a future date. (Hickman, 2012) Still, any attempt to lend direct aid to the Allies would be met with political opposition; Congress as well as many ordinary Americans heeded the warnings of the Nation's first President against entanglements in European Wars. The First World War did little to disabuse the public of this notion. As World War II became inevitable there were few indications that the United States would become a colossal industrial powerhouse that would prove the primary source of military assistance. Although American sympathies were definitely aligned with the nations who opposed Nazi-ism and Fascism, prior to late 1939 (September) the government espoused a policy of strict neutrality, thus little to no effort was made to place the economy on a war footing. The fear of a new European war was real, and compelling.Such fears prompted Congress to pass the Neutrality Act of 1935 and subsequent supporting amendments in 1936 and 1937. The totality of these measures made it illegal to grant loans or export warfare implements to belligerent countries. In addition, the Johnson Act of 1934 prohibited purchases on credit to any nation in default of payments to the United States. Great Britain and France placed large orders for munitions, but were required to pay for their items on a strict "cash and carry" basis. The situation in Europe worsened on September 1, 1939 when Nazi Germany invaded Poland. Two days following the attack, both France and British declared war on Germany; sparking a conflict that was soon to stretch from China, to Ethiopia, and Civil War in Spain. The market for American Munitions was to become global. (Martel, 2007 p.7, p.165) The Neutrality Act placed the federal government in a bind, whereby they needed to freeze pending orders by law at the commencement of open hostilities. Yet the President was sensitive to the undercurrent of sympathy from the American public in support of democratic governments fighting Nazi aggression. The President was also very aware of t he desperate need of Britain and France for American munitions and supplies. Thus, President Franklin Roosevelt called a special session of Congress in order to propose a means to secure legislative relief. On November 4, 1939 Congress passed the Pittman Act, which served to lift the embargo. Supplying French and British orders for munitions aided American industry in the conversion from commercial to the military production that would soon be needed. It also helped the chronic unemployment rates of the Great Depression. To facilitate the transition it was necessary to distribute the orders with equanimity. Rather than devise a special new bureaucracy, the government employed the existing Clearance Committee of the Army and Navy Munitions Board for the purpose of organizing the supply/munitions purchase-leases. Another obstacle to America's effort to equip foreign belligerents was that it was still unlawful to purchase government-owned munitions. To evade this constraint the War Dep artment sold guns and ammunition to the United States Steel Export Company, which served as an intermediary to the

Historical Educational Theorists Letter Essay Example | Topics and Well Written Essays - 750 words

Historical Educational Theorists Letter - Essay Example Indeed, this is a serious concern that can affect any school system, for this reason; there are certain steps that need to be taken into consideration by your administration to restore the system to its full functioning. It is important to understand that the process of real education only happens through the stimulation process of a child’s powers, these often comes about because of social demands that the individual child finds himself in. By interacting with these societal demands, a learner is inspired to act in a way that portrays him as a member of that community. In my perspective, â€Å"I believe that in the ideal school, we have the reconciliation of the individualistic and the institutional ideals† (Dewey, 2013), therefore, you need to outline clearly these separate ideals. In this way, the learner finally graduates to become a useful and reliable member of the school and community. In my view, â€Å"I believe that the child should be stimulated and controlled in his work through the life of the community† (Dewey, 2013), and not being forced to conform to the system that is set. Therefore, what exactly needs to be done? I would prefer that you play the leading role as a leader of the institution to create an environment in which learners can know how to interact with various systems in the school. In this case, create core values that the administration and school community can uphold, they should be values that facilitate proper communication, respect, love and excellence among others. Through these needs, learners will find themselves with the urge to behave in certain ways that are in line with the core values set. Keep in mind that the school is a social community where learners, teachers and other stakeholders play a crucial role in shaping the values of a child for life. The management problems and the poor relationship that exists in your institution can be due to lack of proper awareness about the

Understanding of Macro level practice Case Study

Understanding of Macro level practice - Case Study Example Wodarski and Dziegielewski (2002) state that macro-level practices can be categorized in four dimensions. These dimensions include tasks to meet clients needs, determining where and how changes can be made, assisting clients to get the resources they need and the organization’s perspective. In looking at the client needs, we have to look at how we can create new resources and how we can improve policies and procedures that regulate resource distribution. There are various issues concerning service delivery that need to be adopted by various agencies. One major issue is incorporation of the new technologies when delivering services. Most of the macro-level practices can be understood in a broader base of clients’ community. Hardcastle (2011) tells us that like individuals, every community is uncommon with unique opportunities and challenges. In order to understand macro-level practices in a community, we have to undertake a community assessment. This assessment can help us understand various relevant aspects of a community and it can enable us to know the current conditions and factors necessary to consider achieving the changes we anticipate having in this community. Community assessment can also assist us in identifying assets, resources, and challenges that a community has as per the moment. It can also yield us to know the current state of a community and, thus, recommend what needs to be done for a better future to be achieved. In addition to understanding a community, community assessment also facilitates building a case theory (Hardcastle, 2011). For us to conduct a good community assessment we have to consider the relationships between people and environment. Hardcastle (2011) states that the first step in community assessment is determining critical factors in the community, ecology and task environment. By the end of the community assessment, we

A comparison of the environmental effects of using nuclear energy and Essay

A comparison of the environmental effects of using nuclear energy and coal energy - Essay Example A comparison of the environmental effects of using nuclear energy and coal energy Since the year 1974, there has been no new ground breaking for setting up new nuclear power plants although a number of nuclear reactor units have been constructed at these plants. However, there has recently been a revival of interest in nuclear energy and this new interest has largely been fostered by the Nuclear Power 2010 Program, which was established in the year 2000. There has been an increase in the number of nuclear reactors being constructed since 2010 in existing power plants, such as the one at Watts Bar, Tennessee. In spite of the resurgence of interest in nuclear energy, most of the projects, which have been set up for the construction of nuclear reactors have been recently cancelled. This is mainly due to the economic challenges that are currently gripping the nation as well as the negative reaction that came in the wake of the recent nuclear accidents in Japan. Officials in the nuclear industry state that they only expect about five new nuclear reactors to be working in the next eight years because of the hindrances, which have made most of their projects to stall. Since the beginning of its usage, there has been a lot of debate about the use of nuclear power in the United States and this has recently intensified due to talk of a coming renaissance in the use of nuclear energy (Terzo 1). Some of the most hotly debated issues concerning the use of nuclear energy have been matters concerning the public safety.

Scoring a Basket in Basketball Essay Example for Free

Scoring a Basket in Basketball Essay My task is to produce a strategy necessary for scoring a basket in basketball. I shall investigate the effects of throwing the ball at different angles and ascertain the ideal angle for scoring a basket. In addition, I shall investigate what would be the best angle for me to throw the basketball rather than just the basketball player as the angle will be different as I am much shorter than a basketball player. I will model the motion of the ball as it leaves the hands of the basketball player and falls through the hoop. I will model the basketball as a particle. Basketball is a ball game where if a free throw is taken a player will try and shoot a hoop from the free-throw line which is 4. 61m from the backboard of the hoop. The centre of the hoop is then 382cm from the backboard. Therefore, the centre of the hoop is 4. 22m from the free-throw line. I am taking the height of the basketball hoop as being 3. 053m. I am taking the height of the basketball player to be 1. 984m. My own height is 1. 6m.

Arguments For and Against Euthanasia

Arguments For and Against Euthanasia Euthanasia: Whose decision is it I. Introduction In a 1988 issue of the Journal of the American Medical Association, an article titled Its Over Debbie describes how an anonymous doctor administers a fatal dose of morphine to a woman dying of ovarian cancer (Anonymous, 1988). In a 1989 issue of the New England Journal of Medicine, ten doctors associated with the nations leading hospitals and medical schools declare their belief that it is not immoral for a physician to assist in the rational suicide of a terminally ill person (Wanzer, et. al., 1989). In 1991, the New England Journal of Medicine published a detailed account written by Dr. Timothy Quill which discussed his decision to help a patient suffering from leukemia commit suicide (Quill, 1991). In 1990, Dr. Jack Kervorkian uses his suicide machine to help a woman suffering from Alzheimers disease, one Janet Adkins, end her life in the back of a Volkswagen bus (Risen, 1990). Janet was the first of twenty patients who have been aided by Kervorkian in the past three years. He rem ains committed to his practice. In 1991 the Hemlock Society publishes a how-to manual on committing suicide. Entitled Final Exit, it zooms to the top of the national best seller lists and stays there for several weeks (Altman, 1991). Each of these events has served to provoke ever widening media coverage of the issues surrounding euthanasia and physician assisted suicide, and a national debate has arisen around these practices. This debate is not merely limited to attorneys and physicians. Suddenly, these issues and this debate are now a part of life in mainstream America, and many Americans face dilemmas that did not exist in simpler times; dilemmas that many would rather not have to face. II. Review of the Literature a. Euthanasia: The Nature of the Debate It is this sudden change in the way Americans are dealing with death, the nature and scope of the debate about dying, which prompts this analysis of the issues surrounding euthanasia. This debate is largely a debate about what is ethical. Questions the debate attempts to answer include: Is it right to commit suicide? Is it ethical for someone else to help? Is it right to put others to death at their own request or at the request of family members? These questions are important because they help to define our society and our culture. The way people deal with and respond to issues of life, ritual, and death serves to shape the nature of our society. This is why society must attempt to decide what is right; what is ethical conduct for the various actors in our communities when we face death. There are several reasons why this debate has surfaced in the 1980s. Death is nothing new, it has existed for thousands of years. Each culture has developed its own rituals and mechanisms for dealin g with death. These mechanisms serve to provide solace, a sense of continuity, and allow the culture to continue even as the members of the community cannot. However, our own culture has experienced many shattering changes that have altered the nature of dying. Suddenly we are forced to rethink the issue of death and we must decide what types of behavior are ethical when someone is dying. Before we can examine the debate about the ethics of dying, we must examine why the debate exists. Perhaps the main reason that death has changed in western culture has to do with advances in medicine and technology. Many of the diseases that have historically killed people are now no longer a threat to most individuals. Medicine has made a variety of advances in the treatment of diseases such as smallpox, tuberculosis, malaria, pneumonia, polio, influenza, and measles. People now rarely die of such traditional causes. Life expectancy has risen to almost 75 years in the United States. The quality o f life has also changed fundamentally during the past 100 years. Not only does almost everyone in the United States have enough to eat, but people eat higher on the food chain. There is a great deal more meat and animal fat in modern diets. Just these differences alone have changed death significantly. People now develop heart disease, adult onset diabetes, cancers, and AIDS. These types of diseases are more the result of lifestyle than bacteria. With these new diseases, suffering is often more prolonged and treatment is frequently quite painful. Also, as people are living longer, the diseases of the aged have become increasingly prevalent. Many more people now suffer from problems like senile dementia and Alzheimers disease. These diseases ruin the mind while preserving the body, allowing life to continue long after any quality that the life might have is gone. If what we die of has changed, perhaps the way that we die has changed even more. Throughout history, death has been a family affair. People usually died in the home after a short bout with an illness or as the result of an accident. Today, increasingly, death occurs in an institutional setting such as a convalescent home or a hospital, after a variety of technologies are applied in an attempt to prolong the life of the sick person. Often these technologies can be quite effective. People can now live for months and even years attached to a variety of tubes and technol ogies. About 75% of all deaths in 1987 occurred in hospitals and long term care facilities, up from 50% in 1950 . . . The Office of Technology Assessment Task Force estimated in 1988 that 3775 to 6575 persons were dependent on mechanical ventilation and 1,404,500 persons were receiving artificial nutritional support. This growing capability to forestall death has contributed to the increased attention to medical decisions near the end of life. (CEJA, 1992, p. 2229) People realize that the chances of facing the institutionalization of death increase daily, and they feel a profound lack of control. Surveys have consistently indicated that a large majority of people in the United States would like to be allowed to end their lives before incurable and painful diseases finally kill them (CEJA, p. 2229). Because of the changes that have impacted death, with regard to both how and where we die, the debate about how we should be allowed to die has been renewed. This paper will examine the s everal facets of this debate. It will define the terms that are relevant to the debate, examine the legal state of euthanasia today, discuss the ethics of euthanasia by examining arguments made by proponents and opponents of euthanasia, and by applying several Normative Ethical Theories to the issue. Finally, it will explore the power implications that infuse the debate on euthanasia and present arguments in favor of moving toward a care based ethic of dying and away from the current rights based ethic. b. Definitions If we are to effectively understand the debate about the right to die in the United States, it is imperative that a few basic terms be understood. The first and most important term is euthanasia. Originating from the Greek terms eu (happy or good) and thanatos (death), euthanasia means literally happy death or good death. The American Medical Associations Council on Ethical and Judicial Affairs defines the term as follows: Euthanasia is commonly defined as the act of bringing about the death of a hopelessly ill and suffering person in a relatively quick and painless way for reasons of mercy. In this report, the term euthanasia will signify the medical administration of a lethal agent to a patient for the purpose of relieving the patients intolerable and incurable suffering. (p. 2230) Other sources have defined euthanasia variously: The act or practice of painlessly putting to death persons suffering from incurable conditions of diseases. (Wolhandler, 1984, p. 363), . . . to refuse un wanted medical treatment or to have ongoing care withdrawn even though the patient will die if treatment is terminated. (Adams, et. al., 1992, p. 2021). Euthanasia is a general term that can actually mean a variety of different things depending upon the context in which it is used. For this reason, a number of supporting terms has become the convention when discussing euthanasia. These terms help to narrow the subject matter and distinguish between different types of euthanasia. The important terms that help to subdivide and classify euthanasia by type are voluntary/involuntary and active/passive. Voluntary euthanasia is a death performed by another with the consent of the person being killed. This consent may be in writing as in the case of a living will or advance directive. Involuntary euthanasia is a death performed by another without the consent of the person being killed. The AMAs Council on Ethical and Judicial Affairs makes three distinctions concerning consent and euthanasia: Voluntary euthanasia is euthanasia that is provided to a competent person on his or her informed request. Non-voluntary euthanasia is the provision of euthanasia to an incompetent person according to a surrogates decision. Involuntary euthanasia is euthanasia performed without a c ompetent persons consent.(p. 2230) Wolhandler compares the terms in a different context.Those who condemn euthanasia of both kinds would call the involuntary form murder and the voluntary form a compounded crime of murder and suicide if administered by the physician, and suicide alone if administered by the patient himself. As far as voluntary euthanasia goes, it is impossible to separate it from suicide as a moral category; it is, indeed, a form of suicide. Voluntary euthanasia may involve participation of second parties. (p. 366) The distinction between active and passive euthanasia is not nearly as clear as the previous distinction. Although many authors claim that the difference between the two types cannot be identified or is irrelevant at best, much of the debate on the subject is over this distinction and most of the current legal issues turn on this distinction. While this paper will contend that the difference between the two should not be recognized, it is both useful and important to know where the line is drawn. The AMA, which is strongly opposed to active euthanasia, has seen fit to endorse passive euthanasia in appropriate situations. The Council on Ethical and Judicial Affairs makes the distinction as follows: The physician is obligated only to offer sound medical treatment and to refrain from providing treatments that are detrimental, on balance, to the patients well being. When a physician withholds or withdraws a treatment on the request of a patient, he or she has fulfilled the obligation to offer sound treatment to the patient. The obligation to offer treatment does not include an obligation to impose treatment on an unwilling patient. In addition, the physician is not providing a harmful treatment. Withdrawing or withholding is not a treatment, but the foregoing of a treatment. (p. 2231) According to Wolhandler, (p. 367) it is t he nature of the acts performed by the second party that distinguishes between active and passive euthanasia. The courts have held that acts of omission (removal of respiratory assistance, hydration, and feeding tubes) are allowable behavior. Although unplugging a respirator and switching off a dialysis machine are arguably acts of commission, an increasing number of judges and commentators have accepted these acts as permissible passive euthanasia in both voluntary and involuntary settings. Gifford (1993) describes the difference between the two types of euthanasia this way: Passive euthanasia involves allowing a patient to die by removing her from artificial life support systems such as respirators and feeding tubes or simply discontinuing medical treatments necessary to sustain life. Active euthanasia, by contrast, involves positive steps to end the life of a patient, typically by lethal injectiond (p. 1546) The right to passive euthanasia has also been termed the right to die by some authors (Adams, et. al., p. 2021-22). With an understanding of the different types of euthanasia, we can now define some other key terms. It is important to understand how physician assisted suicide differs from euthanasia, and it is also necessary to define the terms advance directive and competence since they are crucial in determining the difference between voluntary and involuntary euthanasia. The term physician assisted suicide is somewhat self-explanatory. It occurs when a physician provides aid to a patient so they can commit suicide. However, it is also necessary to see the difference between this type of action and euthanasia. The AMAs Council on Ethical and Judicial Affairs states that Euthanasia and assisted suicide differ in the degree of physician participation. Euthanasia entails a physician performing the immediate life ending action (e.g., administering a lethal injection). Assisted suicide occurs when a physician facilitates a patients death by providing the necessary means and/or information to enable the patient to perform the life-ending act (e.g., the physician provides sleeping pills and information about the lethal dose, while aware that the patient may commit suicide). (p. 2231) It is important to realize that the difference between euthanasia and assisted suicide lies in the behavior of the physician. This difference in behavior has recently become a major legal battleground that will be explored in the following pages. The advance directive has recently become an important new device to aid the terminally ill. Many states have legalized the advance directive, partly in an attempt to avoid dealing with problems associated with active euthanasia, and partly to help ease the burdens on the dying and their families. Singer (1992) provides a good definition of advance directive and explains how it is used. An advance directive is a written document completed by a competent person that aims to guide medical treatment after the person becomes incompetent. There are two types: instruction directives, which focus on the types of life-sustaining treatment that the person would want under various clinical situations, and proxy directives, which focus on who the person would want to make health care decisions if the person were unable to do so. (p. 22) The advance directive is useful because it can theoretically eliminate the need for involuntary euthanasia. It ensures that a voluntary decision is made in advance, even if the individual could not make such a situation at a later date. If everyone made use of the advance directive, there would be no need to debate policy decisions that must be made in the case of an incompetent person on life support. Because advance directives have neither been accepted nor widely used by the general public, many of the problems that could potentially be solved remain. This situation caused right to die groups in both California and Washington to propose ballot initiatives that would legalize active euthanasia (Gifford, p. 1550-51). Although active euthanasia is not legal in any United States jurisdiction, passive euthanasia is generally allowed at the request of a competent individual. Because of this it is critical to understand what constitutes competence. Courts have defined legal competence as the mental ability to make a rational decision, which includes the ability to perceive, appreciate all the relevant facts, and to reach a rational judgement upon such facts. In the euthanasia context, legal competence is the incurable s ability to understand that in requesting active euthanasia he is choosing death over life. Only clear and convincing evidence should suffice for a finding of an incurables competence. (Wolhandler, p. 366-67) c. The Legal State of Euthanasia With a knowledge of the meaningful terms that will be involved, it is important to discuss the legal state of euthanasia in the United States today. As technology has placed more and more people on life sustaining devices in this country, the courts have had to deal with several cases that pertain to euthanasia in a variety of ways. This section of the paper is designed to review those cases briefly and to assess how the rulings in those cases have set the policy for the practice of euthanasia today. The courts first dealt with euthanasia in the Quinlan case in 1976. Karen Ann Quinlan lapsed into a coma after mixing a variety of pills and alcohol at a party. After it became apparent that she would not be revived, her parents went to court to have her respirator removed. The New Jersey Supreme Court ruled that her parents had the right to have the respirator removed and that Karen be allowed to die. Ironically, because her parents did not request removal of feeding and hydration tubes , she survived nine more years curled in a fetal position in a New Jersey rest home (Wolhandler, p. 366). In this case, the New Jersey court effectively sanctioned nonvoluntary passive euthanasia. The next prominent case was decided by the New York Supreme Court in Superintendent of Belchertown State School v. Saikewicz. Here the court found that a competent patient had the right to refuse medical treatment, allowing for a patient to decide in cases of voluntary passive euthanasia (Gifford, p. 1575-76). Later, in Satz v. Perlmutter, a Florida District Court of Appeals came to essentially the same conclusion (Wolhandler, p. 372-73). In Severns v. Wilmington Medical Center, the Delaware Supreme Court gave the husband of a comatose woman the right of guardianship and the authority to remove her respirator or withhold other treatment as he saw fit. In this case the court relied on previous decisions made in Quinlan, Saikewicz, and Satz for its finding (Wolhandler, p. 373). In Thor v. Su perior Court (California), the court granted the request to withhold treatment from a severely depressed quadriplegic only after a psychiatric evaluation determined that the request was based on poor quality of life and not just on severe depression (Pugliese, 1993, p. 1326). The courts have not restricted the right of passive euthanasia to just the terminally ill. Elizabeth Bouvia was a relatively young woman who suffered from severe cerebral palsy and attempted to starve herself to death in a California hospital by requesting the removal of a nasogastric feeding tube. She was denied this request because the hospital feared it would be party to suicide. The California court of appeals ordered the physicians to remove the tube and argued that she had the right to enlist the assistance of others in ending her life (Sprung, 1990, p. 2213). The courts have also found that doctors and hospitals must at least obtain consent from third parties that would have a significant interest in the patients outcome if the patient is incompetent. In the case of Helga Wanglie, a Minnesota court denied a hospital administrator permission to disconnect her respirator against the wishes of her husband (Gifford, p. 1571). In sum, these cases indicate an emerging consensus that courts will generally allow treatment to be withheld from patients who are terminally ill if it is in the best interests of the patient and at the request of patients or family members. It is this emerging consensus that made the U.S. Supreme Courts decision in the Cruzan case so interesting. In the only euthanasia case heard to date by the U.S. Supreme Court, the justices, in a 5-4 decision, allowed to stand the decision made by the Missouri Court of Appeals not to disconnect the life support apparatus from Nancy Cruzan (Cruzan v. Director, Missouri Dept. of Health, 1990). Although the court did find that a right to refuse treatment could be found in the Due Process clause of the Fourteenth Amendment, and did not prohibit the courts from looking in other areas for this right (Adams, et. al., p. 2025), it also upheld the right of the State of Missouri to require . . . clear and convincing evidence that Ms. Cruzan would have desired withdrawal of these treatments. (Newman, 1991, p. 175). In the realm of physician assisted suicide, only two major cases have been decided. In the case against Dr. Timothy Quill that arose because of the publication of his article in the New England Journal of Medicine, the grand jury for the state of New York refused to return an indictment (Bender, 1992, p. 524). In the more publicized case of Dr. Jack Kervorkian, the courts have not yet decided on the constitutionality of the Michigan law that bans physician-assisted suicide. Kervorkian is currently free on bond and continues to aid other patients who wish to commit suicide (Pugliese, p. 1300-05).(1) A brief assessment of the cases described above indicates that the courts have essentially legalized voluntary passive euthanasia, finding justification to refuse or have medical treatment withheld in the constitutional right to privacy, the common law right of self determination, or the more general concept of autonomy (Gifford, p. 1575-78). With regard to involuntary passive euthanasia, the courts are generally supportive of the practice, but they have the right to insist on a more stringent standard of evidence before approving such procedures. The courts have generally employed a balancing test that weighs the patients right to privacy and self-determination against the interest of the state in preserving life. The interests of potential third parties that might desire that the patient continue to live, and the ethical image of the medical profession (Adams, et. al., p. 2022). In cases of assisted suicide, some states have laws against the practice, the AMA forbids it, most juries are refusing to find the actors guilty, and the courts have yet to decide the question. Both voluntary and involuntary active euthanasia remain illegal. d. The Debate About Euthanasia The movement to legalize active euthanasia has existed for quite some time. Initially popularized in Britain during the 19th century, it gained some adherents in the United States during the 1920s. It was the Nazi program of active euthanasia in the 1930s and 4os that cast a pall of disrepute over the practice that remains today. The revival of this movement today can largely be attributed to the onset of the issues discussed at the beginning of this paper, and to the efforts of the Hemlock Society, a group of individuals that actively promotes the right to dignified death. The Hemlock Society recently promoted ballot initiatives in both Washington and California that would have legalized active euthanasia in those states (Gifford, 1993). This revival of the right to die movement has led to hotly contested debate about the practices of active euthanasia and physician assisted suicide. This paper will attempt to encapsulate this debate by presenting the arguments made by both opponents and supporters of these procedures. Since arguments made by both sides are used in cases of euthanasia and assisted suicide, the generic term euthanasia is used for simplicity to suggest the concept of aided death unless otherwise indicated. Those opposed to euthanasia and assisted suicide present a variety of arguments in support of a ban. e. The Case Against Euthanasia Euthanasia destroys societal respect for life. By becoming commonplace and used in medical practice along with more traditional methods of healing, society becomes desensitized toward death to the point where life is no longer valuable. This attitude serves to degrade humanity and leads to a variety of social ills. In a society that devalues life, people have no compunctions about committing violent crimes and murdering others. The overall quality of life becomes seriously undermined and society as a whole deteriorates (Doerflinger, 1989, p. 16-19, Koop, 1989, p. 2-3). Once euthanasia becomes legal, opponents contend, the potential for abuse at the hands of caregivers vastly increases. Closely related to this argument is the argument that those who enjoy the exercise of power over others might become intoxicated with it and actually come to enjoy killing. One step down the path toward euthanasia simply makes it that much easier in the future to take further steps. This argument is al so referred to as the wedge theory or the slippery slope. One of the most outspoken opponents of euthanasia, University of Michigan professor of law Yale Kamisar, has articulated a three pronged attack that utilizes the wedge theory, the risk of abuse, and the risk of mistake. The proponents of the wedge theory argue that Once society accepts that life can be terminated because of its diminished quality, there is no rational way to limit euthanasia and prevent its abuse. According to this theory, voluntary euthanasia is just the thin edge of a wedge that, once in place, will be driven deeply into our society. Kamisar concludes that legalized voluntary euthanasia inevitably would lead to legalized involuntary euthanasia because it is impossible to draw a rational distinction between those who seek to die because they are a burden to themselves and those whom society seeks to kill because they are a burden to others.(2) (Wolhandler, p. 377) Many who raise the wedge or slippery slope a rgument use the Nazi experience with euthanasia as an empirical example of this process in action. They argue that a public policy of murder inexorably follows from an initial, limited step, namely the adoption of a carefully defined euthanasia program, and that a program designed to get rid of those with lives unworthy of life quickly degenerated into the holocaust (Newman, p. 167). What follows is a description of the Nazi euthanasia program excerpted from Liftons (1986) book: National Socialist euthanasia or mercy death was a program of killing persons with unworthy lives. These persons were not moribund, and their families, with the rarest exceptions, wanted them to live. It was not a good death, as the word denotes, but a systematic program of killing without any mercy whatsoever . . . The program, referred to in the National Socialist bureaucracy as T4, was not based on any law, but was initiated by a secret order traceable to Hitler and his chief physician, Karl Brandt . Ment al hospitals were required to report all chronic schizophrenics, manic-depressives, mental defectives, epileptics, and later, debilitated old persons. A separate division, the Public Transport division for the Sick, took care of the collection and transport of such patients to institutions where they were put to death . Relatives received false death certificates and even letters of condolence . . . It is estimated that during two years of this program, ninety thousand persons went to their deaths. While this description of the Nazi euthanasia program is indeed chilling, it provides within it a devastating attack against using it as justification for the slippery slope argument. Proponents of euthanasia in the United States point out that the Nazi program was not one of euthanasia, but a program of mass murder disguised as euthanasia. Gifford (p. 1570) sums up the response of several authors by stating that The Nazis hid their racist, eugenic agenda behind the term euthanasia, termi nating in secret the lives of undesirables. It must never be forgotten that the Nazi euthanasia program was never euthanasia at all. That the Nazis co-opted the term for their own purposes should not obscure the fact that their motive was, from the very beginning, entirely different from that of todays euthanasia proponents. The current euthanasia movement is anything but covert. The Hemlock Society and other supporters of the right to receive aid in dying have spent millions of dollars to publicize their efforts. In this context, death is presented as a positive alternative to pain and suffering, not a utilitarian tool. Proponents of euthanasia also attempt to refute the slippery slope argument in a variety of other ways. They contend that the current mechanisms used by the courts could easily prevent any slide toward involuntary euthanasia,(3) that the current practice of passive euthanasia proves that the slope isnt all that slippery since we havent witnessed any massive killing programs, and that the example of how forced sterilization in the U.S. has diminished rather than increased, provides a more appropriate example to rely on. Even Callahan (1989), a vocal opponent of active euthanasia, admits that the Nazi experience is not particularly applicable to the U.S. experience and that Lives are not b eing shortened. They are steadily being lengthened, and particularly for those who are the most powerless: sick children and the very old, the mentally and mentally retarded, the disabled and the demented (p. 4). Newman (1991) also attacks the concept of the slippery slope itself. Arguing that just pointing out that one type of action could conceivably lead to another constitutes a very unpersuasive argument and that for the premise to hold true, it must be shown that pressure to allow further steps will be so strong that these steps will actually occur. He also reminds us that such arguments are frequently abused in legal and social policy debate (p. 169). Besides Kamisar, the risk of abuse argument has also been put forth by a host of other authors who variously claim that assisted suicides might result in flagrant murders that may be perpetrated by deliberately forcing or coercing self-destruction and that others may advance personal motives by aiding in suicide (Adams, et. al., p. 2031); that when the entire medical profession is involved in euthanasia, including the poorly trained, the insensitive, the less skilled, there becomes the danger that physicians might not do whatever they can to avoid euthanasia if possible (Newman, p. 177); and that some people who enjoy the exercise of power over others might become addicted to the process (Doerflinger, p. 19). It is this fear of abuse that leads the AMAs Council on Ethical and Judicial Affairs to argue that the ban on active euthanasia is a bright line distinction that deters this type of potential abuse. They state: Allowing physicians to perform euthanasia for a limited group of patients who may truly benefit from it will present difficult line-drawing problems for medicine and society. In specific cases it may be hard to distinguish which cases fit the criteria established for euthanasia. For example, if the existence of unbearable pain and suffering was a criterion for euthanasia, the definition of unbea rable pain and suffering could be subject to different interpretations, which might lead to abuse of the process in the case of certain practitioners. (CEJA, p. 2232). Proponents of euthanasia argue that the risk of abuse, while certainly present, is not really much of a threat. This is true first, because laws against homicide are severe enough to provide a strong deterrent (Newman, p. 178); second, because a clear set of guidelines prescribing when active euthanasia is allowed will prevent confusion (Adams, et. al., Gifford); third, because we already risk the practice of abuse by allowing passive euthanasia, and such abuse has not occurred (Newman, p. 178); and finally, that the current state of illegality promotes an absence of discussion and actually encourages the practice of clandestine euthanasia (Newman, p. 177). As Gifford (p. 1572) succinctly puts it, what slope could be more slippery than one with no guardrails whatsoever? Additionally, the balancing tests already in place by the legal system should serve to eliminate this problem. Adams, et. al., (p. 2034) explain: For example, some opponents of physician-assisted suicide argue that pe rmitting some assisted suicides may lead to the killing of patients who want to live. This slippery slope argument expresses a utilitarian rationale for prohibiting suicide assistance. Others argue that suicide and the assistance of suicide is intrinsically evil, and that sanctioning them will damage the fabric of social morality. These and other utilitarian and moral considerations are encompassed within the states interest in preserving the sanctity of all life and affect its weight in the balance against the patients interest in self-determination. Opponents of euthanasia contend that there is no guarantee that euthanasia will be strictly voluntary. The potential for sub Arguments For and Against Euthanasia Arguments For and Against Euthanasia Euthanasia: Whose decision is it I. Introduction In a 1988 issue of the Journal of the American Medical Association, an article titled Its Over Debbie describes how an anonymous doctor administers a fatal dose of morphine to a woman dying of ovarian cancer (Anonymous, 1988). In a 1989 issue of the New England Journal of Medicine, ten doctors associated with the nations leading hospitals and medical schools declare their belief that it is not immoral for a physician to assist in the rational suicide of a terminally ill person (Wanzer, et. al., 1989). In 1991, the New England Journal of Medicine published a detailed account written by Dr. Timothy Quill which discussed his decision to help a patient suffering from leukemia commit suicide (Quill, 1991). In 1990, Dr. Jack Kervorkian uses his suicide machine to help a woman suffering from Alzheimers disease, one Janet Adkins, end her life in the back of a Volkswagen bus (Risen, 1990). Janet was the first of twenty patients who have been aided by Kervorkian in the past three years. He rem ains committed to his practice. In 1991 the Hemlock Society publishes a how-to manual on committing suicide. Entitled Final Exit, it zooms to the top of the national best seller lists and stays there for several weeks (Altman, 1991). Each of these events has served to provoke ever widening media coverage of the issues surrounding euthanasia and physician assisted suicide, and a national debate has arisen around these practices. This debate is not merely limited to attorneys and physicians. Suddenly, these issues and this debate are now a part of life in mainstream America, and many Americans face dilemmas that did not exist in simpler times; dilemmas that many would rather not have to face. II. Review of the Literature a. Euthanasia: The Nature of the Debate It is this sudden change in the way Americans are dealing with death, the nature and scope of the debate about dying, which prompts this analysis of the issues surrounding euthanasia. This debate is largely a debate about what is ethical. Questions the debate attempts to answer include: Is it right to commit suicide? Is it ethical for someone else to help? Is it right to put others to death at their own request or at the request of family members? These questions are important because they help to define our society and our culture. The way people deal with and respond to issues of life, ritual, and death serves to shape the nature of our society. This is why society must attempt to decide what is right; what is ethical conduct for the various actors in our communities when we face death. There are several reasons why this debate has surfaced in the 1980s. Death is nothing new, it has existed for thousands of years. Each culture has developed its own rituals and mechanisms for dealin g with death. These mechanisms serve to provide solace, a sense of continuity, and allow the culture to continue even as the members of the community cannot. However, our own culture has experienced many shattering changes that have altered the nature of dying. Suddenly we are forced to rethink the issue of death and we must decide what types of behavior are ethical when someone is dying. Before we can examine the debate about the ethics of dying, we must examine why the debate exists. Perhaps the main reason that death has changed in western culture has to do with advances in medicine and technology. Many of the diseases that have historically killed people are now no longer a threat to most individuals. Medicine has made a variety of advances in the treatment of diseases such as smallpox, tuberculosis, malaria, pneumonia, polio, influenza, and measles. People now rarely die of such traditional causes. Life expectancy has risen to almost 75 years in the United States. The quality o f life has also changed fundamentally during the past 100 years. Not only does almost everyone in the United States have enough to eat, but people eat higher on the food chain. There is a great deal more meat and animal fat in modern diets. Just these differences alone have changed death significantly. People now develop heart disease, adult onset diabetes, cancers, and AIDS. These types of diseases are more the result of lifestyle than bacteria. With these new diseases, suffering is often more prolonged and treatment is frequently quite painful. Also, as people are living longer, the diseases of the aged have become increasingly prevalent. Many more people now suffer from problems like senile dementia and Alzheimers disease. These diseases ruin the mind while preserving the body, allowing life to continue long after any quality that the life might have is gone. If what we die of has changed, perhaps the way that we die has changed even more. Throughout history, death has been a family affair. People usually died in the home after a short bout with an illness or as the result of an accident. Today, increasingly, death occurs in an institutional setting such as a convalescent home or a hospital, after a variety of technologies are applied in an attempt to prolong the life of the sick person. Often these technologies can be quite effective. People can now live for months and even years attached to a variety of tubes and technol ogies. About 75% of all deaths in 1987 occurred in hospitals and long term care facilities, up from 50% in 1950 . . . The Office of Technology Assessment Task Force estimated in 1988 that 3775 to 6575 persons were dependent on mechanical ventilation and 1,404,500 persons were receiving artificial nutritional support. This growing capability to forestall death has contributed to the increased attention to medical decisions near the end of life. (CEJA, 1992, p. 2229) People realize that the chances of facing the institutionalization of death increase daily, and they feel a profound lack of control. Surveys have consistently indicated that a large majority of people in the United States would like to be allowed to end their lives before incurable and painful diseases finally kill them (CEJA, p. 2229). Because of the changes that have impacted death, with regard to both how and where we die, the debate about how we should be allowed to die has been renewed. This paper will examine the s everal facets of this debate. It will define the terms that are relevant to the debate, examine the legal state of euthanasia today, discuss the ethics of euthanasia by examining arguments made by proponents and opponents of euthanasia, and by applying several Normative Ethical Theories to the issue. Finally, it will explore the power implications that infuse the debate on euthanasia and present arguments in favor of moving toward a care based ethic of dying and away from the current rights based ethic. b. Definitions If we are to effectively understand the debate about the right to die in the United States, it is imperative that a few basic terms be understood. The first and most important term is euthanasia. Originating from the Greek terms eu (happy or good) and thanatos (death), euthanasia means literally happy death or good death. The American Medical Associations Council on Ethical and Judicial Affairs defines the term as follows: Euthanasia is commonly defined as the act of bringing about the death of a hopelessly ill and suffering person in a relatively quick and painless way for reasons of mercy. In this report, the term euthanasia will signify the medical administration of a lethal agent to a patient for the purpose of relieving the patients intolerable and incurable suffering. (p. 2230) Other sources have defined euthanasia variously: The act or practice of painlessly putting to death persons suffering from incurable conditions of diseases. (Wolhandler, 1984, p. 363), . . . to refuse un wanted medical treatment or to have ongoing care withdrawn even though the patient will die if treatment is terminated. (Adams, et. al., 1992, p. 2021). Euthanasia is a general term that can actually mean a variety of different things depending upon the context in which it is used. For this reason, a number of supporting terms has become the convention when discussing euthanasia. These terms help to narrow the subject matter and distinguish between different types of euthanasia. The important terms that help to subdivide and classify euthanasia by type are voluntary/involuntary and active/passive. Voluntary euthanasia is a death performed by another with the consent of the person being killed. This consent may be in writing as in the case of a living will or advance directive. Involuntary euthanasia is a death performed by another without the consent of the person being killed. The AMAs Council on Ethical and Judicial Affairs makes three distinctions concerning consent and euthanasia: Voluntary euthanasia is euthanasia that is provided to a competent person on his or her informed request. Non-voluntary euthanasia is the provision of euthanasia to an incompetent person according to a surrogates decision. Involuntary euthanasia is euthanasia performed without a c ompetent persons consent.(p. 2230) Wolhandler compares the terms in a different context.Those who condemn euthanasia of both kinds would call the involuntary form murder and the voluntary form a compounded crime of murder and suicide if administered by the physician, and suicide alone if administered by the patient himself. As far as voluntary euthanasia goes, it is impossible to separate it from suicide as a moral category; it is, indeed, a form of suicide. Voluntary euthanasia may involve participation of second parties. (p. 366) The distinction between active and passive euthanasia is not nearly as clear as the previous distinction. Although many authors claim that the difference between the two types cannot be identified or is irrelevant at best, much of the debate on the subject is over this distinction and most of the current legal issues turn on this distinction. While this paper will contend that the difference between the two should not be recognized, it is both useful and important to know where the line is drawn. The AMA, which is strongly opposed to active euthanasia, has seen fit to endorse passive euthanasia in appropriate situations. The Council on Ethical and Judicial Affairs makes the distinction as follows: The physician is obligated only to offer sound medical treatment and to refrain from providing treatments that are detrimental, on balance, to the patients well being. When a physician withholds or withdraws a treatment on the request of a patient, he or she has fulfilled the obligation to offer sound treatment to the patient. The obligation to offer treatment does not include an obligation to impose treatment on an unwilling patient. In addition, the physician is not providing a harmful treatment. Withdrawing or withholding is not a treatment, but the foregoing of a treatment. (p. 2231) According to Wolhandler, (p. 367) it is t he nature of the acts performed by the second party that distinguishes between active and passive euthanasia. The courts have held that acts of omission (removal of respiratory assistance, hydration, and feeding tubes) are allowable behavior. Although unplugging a respirator and switching off a dialysis machine are arguably acts of commission, an increasing number of judges and commentators have accepted these acts as permissible passive euthanasia in both voluntary and involuntary settings. Gifford (1993) describes the difference between the two types of euthanasia this way: Passive euthanasia involves allowing a patient to die by removing her from artificial life support systems such as respirators and feeding tubes or simply discontinuing medical treatments necessary to sustain life. Active euthanasia, by contrast, involves positive steps to end the life of a patient, typically by lethal injectiond (p. 1546) The right to passive euthanasia has also been termed the right to die by some authors (Adams, et. al., p. 2021-22). With an understanding of the different types of euthanasia, we can now define some other key terms. It is important to understand how physician assisted suicide differs from euthanasia, and it is also necessary to define the terms advance directive and competence since they are crucial in determining the difference between voluntary and involuntary euthanasia. The term physician assisted suicide is somewhat self-explanatory. It occurs when a physician provides aid to a patient so they can commit suicide. However, it is also necessary to see the difference between this type of action and euthanasia. The AMAs Council on Ethical and Judicial Affairs states that Euthanasia and assisted suicide differ in the degree of physician participation. Euthanasia entails a physician performing the immediate life ending action (e.g., administering a lethal injection). Assisted suicide occurs when a physician facilitates a patients death by providing the necessary means and/or information to enable the patient to perform the life-ending act (e.g., the physician provides sleeping pills and information about the lethal dose, while aware that the patient may commit suicide). (p. 2231) It is important to realize that the difference between euthanasia and assisted suicide lies in the behavior of the physician. This difference in behavior has recently become a major legal battleground that will be explored in the following pages. The advance directive has recently become an important new device to aid the terminally ill. Many states have legalized the advance directive, partly in an attempt to avoid dealing with problems associated with active euthanasia, and partly to help ease the burdens on the dying and their families. Singer (1992) provides a good definition of advance directive and explains how it is used. An advance directive is a written document completed by a competent person that aims to guide medical treatment after the person becomes incompetent. There are two types: instruction directives, which focus on the types of life-sustaining treatment that the person would want under various clinical situations, and proxy directives, which focus on who the person would want to make health care decisions if the person were unable to do so. (p. 22) The advance directive is useful because it can theoretically eliminate the need for involuntary euthanasia. It ensures that a voluntary decision is made in advance, even if the individual could not make such a situation at a later date. If everyone made use of the advance directive, there would be no need to debate policy decisions that must be made in the case of an incompetent person on life support. Because advance directives have neither been accepted nor widely used by the general public, many of the problems that could potentially be solved remain. This situation caused right to die groups in both California and Washington to propose ballot initiatives that would legalize active euthanasia (Gifford, p. 1550-51). Although active euthanasia is not legal in any United States jurisdiction, passive euthanasia is generally allowed at the request of a competent individual. Because of this it is critical to understand what constitutes competence. Courts have defined legal competence as the mental ability to make a rational decision, which includes the ability to perceive, appreciate all the relevant facts, and to reach a rational judgement upon such facts. In the euthanasia context, legal competence is the incurable s ability to understand that in requesting active euthanasia he is choosing death over life. Only clear and convincing evidence should suffice for a finding of an incurables competence. (Wolhandler, p. 366-67) c. The Legal State of Euthanasia With a knowledge of the meaningful terms that will be involved, it is important to discuss the legal state of euthanasia in the United States today. As technology has placed more and more people on life sustaining devices in this country, the courts have had to deal with several cases that pertain to euthanasia in a variety of ways. This section of the paper is designed to review those cases briefly and to assess how the rulings in those cases have set the policy for the practice of euthanasia today. The courts first dealt with euthanasia in the Quinlan case in 1976. Karen Ann Quinlan lapsed into a coma after mixing a variety of pills and alcohol at a party. After it became apparent that she would not be revived, her parents went to court to have her respirator removed. The New Jersey Supreme Court ruled that her parents had the right to have the respirator removed and that Karen be allowed to die. Ironically, because her parents did not request removal of feeding and hydration tubes , she survived nine more years curled in a fetal position in a New Jersey rest home (Wolhandler, p. 366). In this case, the New Jersey court effectively sanctioned nonvoluntary passive euthanasia. The next prominent case was decided by the New York Supreme Court in Superintendent of Belchertown State School v. Saikewicz. Here the court found that a competent patient had the right to refuse medical treatment, allowing for a patient to decide in cases of voluntary passive euthanasia (Gifford, p. 1575-76). Later, in Satz v. Perlmutter, a Florida District Court of Appeals came to essentially the same conclusion (Wolhandler, p. 372-73). In Severns v. Wilmington Medical Center, the Delaware Supreme Court gave the husband of a comatose woman the right of guardianship and the authority to remove her respirator or withhold other treatment as he saw fit. In this case the court relied on previous decisions made in Quinlan, Saikewicz, and Satz for its finding (Wolhandler, p. 373). In Thor v. Su perior Court (California), the court granted the request to withhold treatment from a severely depressed quadriplegic only after a psychiatric evaluation determined that the request was based on poor quality of life and not just on severe depression (Pugliese, 1993, p. 1326). The courts have not restricted the right of passive euthanasia to just the terminally ill. Elizabeth Bouvia was a relatively young woman who suffered from severe cerebral palsy and attempted to starve herself to death in a California hospital by requesting the removal of a nasogastric feeding tube. She was denied this request because the hospital feared it would be party to suicide. The California court of appeals ordered the physicians to remove the tube and argued that she had the right to enlist the assistance of others in ending her life (Sprung, 1990, p. 2213). The courts have also found that doctors and hospitals must at least obtain consent from third parties that would have a significant interest in the patients outcome if the patient is incompetent. In the case of Helga Wanglie, a Minnesota court denied a hospital administrator permission to disconnect her respirator against the wishes of her husband (Gifford, p. 1571). In sum, these cases indicate an emerging consensus that courts will generally allow treatment to be withheld from patients who are terminally ill if it is in the best interests of the patient and at the request of patients or family members. It is this emerging consensus that made the U.S. Supreme Courts decision in the Cruzan case so interesting. In the only euthanasia case heard to date by the U.S. Supreme Court, the justices, in a 5-4 decision, allowed to stand the decision made by the Missouri Court of Appeals not to disconnect the life support apparatus from Nancy Cruzan (Cruzan v. Director, Missouri Dept. of Health, 1990). Although the court did find that a right to refuse treatment could be found in the Due Process clause of the Fourteenth Amendment, and did not prohibit the courts from looking in other areas for this right (Adams, et. al., p. 2025), it also upheld the right of the State of Missouri to require . . . clear and convincing evidence that Ms. Cruzan would have desired withdrawal of these treatments. (Newman, 1991, p. 175). In the realm of physician assisted suicide, only two major cases have been decided. In the case against Dr. Timothy Quill that arose because of the publication of his article in the New England Journal of Medicine, the grand jury for the state of New York refused to return an indictment (Bender, 1992, p. 524). In the more publicized case of Dr. Jack Kervorkian, the courts have not yet decided on the constitutionality of the Michigan law that bans physician-assisted suicide. Kervorkian is currently free on bond and continues to aid other patients who wish to commit suicide (Pugliese, p. 1300-05).(1) A brief assessment of the cases described above indicates that the courts have essentially legalized voluntary passive euthanasia, finding justification to refuse or have medical treatment withheld in the constitutional right to privacy, the common law right of self determination, or the more general concept of autonomy (Gifford, p. 1575-78). With regard to involuntary passive euthanasia, the courts are generally supportive of the practice, but they have the right to insist on a more stringent standard of evidence before approving such procedures. The courts have generally employed a balancing test that weighs the patients right to privacy and self-determination against the interest of the state in preserving life. The interests of potential third parties that might desire that the patient continue to live, and the ethical image of the medical profession (Adams, et. al., p. 2022). In cases of assisted suicide, some states have laws against the practice, the AMA forbids it, most juries are refusing to find the actors guilty, and the courts have yet to decide the question. Both voluntary and involuntary active euthanasia remain illegal. d. The Debate About Euthanasia The movement to legalize active euthanasia has existed for quite some time. Initially popularized in Britain during the 19th century, it gained some adherents in the United States during the 1920s. It was the Nazi program of active euthanasia in the 1930s and 4os that cast a pall of disrepute over the practice that remains today. The revival of this movement today can largely be attributed to the onset of the issues discussed at the beginning of this paper, and to the efforts of the Hemlock Society, a group of individuals that actively promotes the right to dignified death. The Hemlock Society recently promoted ballot initiatives in both Washington and California that would have legalized active euthanasia in those states (Gifford, 1993). This revival of the right to die movement has led to hotly contested debate about the practices of active euthanasia and physician assisted suicide. This paper will attempt to encapsulate this debate by presenting the arguments made by both opponents and supporters of these procedures. Since arguments made by both sides are used in cases of euthanasia and assisted suicide, the generic term euthanasia is used for simplicity to suggest the concept of aided death unless otherwise indicated. Those opposed to euthanasia and assisted suicide present a variety of arguments in support of a ban. e. The Case Against Euthanasia Euthanasia destroys societal respect for life. By becoming commonplace and used in medical practice along with more traditional methods of healing, society becomes desensitized toward death to the point where life is no longer valuable. This attitude serves to degrade humanity and leads to a variety of social ills. In a society that devalues life, people have no compunctions about committing violent crimes and murdering others. The overall quality of life becomes seriously undermined and society as a whole deteriorates (Doerflinger, 1989, p. 16-19, Koop, 1989, p. 2-3). Once euthanasia becomes legal, opponents contend, the potential for abuse at the hands of caregivers vastly increases. Closely related to this argument is the argument that those who enjoy the exercise of power over others might become intoxicated with it and actually come to enjoy killing. One step down the path toward euthanasia simply makes it that much easier in the future to take further steps. This argument is al so referred to as the wedge theory or the slippery slope. One of the most outspoken opponents of euthanasia, University of Michigan professor of law Yale Kamisar, has articulated a three pronged attack that utilizes the wedge theory, the risk of abuse, and the risk of mistake. The proponents of the wedge theory argue that Once society accepts that life can be terminated because of its diminished quality, there is no rational way to limit euthanasia and prevent its abuse. According to this theory, voluntary euthanasia is just the thin edge of a wedge that, once in place, will be driven deeply into our society. Kamisar concludes that legalized voluntary euthanasia inevitably would lead to legalized involuntary euthanasia because it is impossible to draw a rational distinction between those who seek to die because they are a burden to themselves and those whom society seeks to kill because they are a burden to others.(2) (Wolhandler, p. 377) Many who raise the wedge or slippery slope a rgument use the Nazi experience with euthanasia as an empirical example of this process in action. They argue that a public policy of murder inexorably follows from an initial, limited step, namely the adoption of a carefully defined euthanasia program, and that a program designed to get rid of those with lives unworthy of life quickly degenerated into the holocaust (Newman, p. 167). What follows is a description of the Nazi euthanasia program excerpted from Liftons (1986) book: National Socialist euthanasia or mercy death was a program of killing persons with unworthy lives. These persons were not moribund, and their families, with the rarest exceptions, wanted them to live. It was not a good death, as the word denotes, but a systematic program of killing without any mercy whatsoever . . . The program, referred to in the National Socialist bureaucracy as T4, was not based on any law, but was initiated by a secret order traceable to Hitler and his chief physician, Karl Brandt . Ment al hospitals were required to report all chronic schizophrenics, manic-depressives, mental defectives, epileptics, and later, debilitated old persons. A separate division, the Public Transport division for the Sick, took care of the collection and transport of such patients to institutions where they were put to death . Relatives received false death certificates and even letters of condolence . . . It is estimated that during two years of this program, ninety thousand persons went to their deaths. While this description of the Nazi euthanasia program is indeed chilling, it provides within it a devastating attack against using it as justification for the slippery slope argument. Proponents of euthanasia in the United States point out that the Nazi program was not one of euthanasia, but a program of mass murder disguised as euthanasia. Gifford (p. 1570) sums up the response of several authors by stating that The Nazis hid their racist, eugenic agenda behind the term euthanasia, termi nating in secret the lives of undesirables. It must never be forgotten that the Nazi euthanasia program was never euthanasia at all. That the Nazis co-opted the term for their own purposes should not obscure the fact that their motive was, from the very beginning, entirely different from that of todays euthanasia proponents. The current euthanasia movement is anything but covert. The Hemlock Society and other supporters of the right to receive aid in dying have spent millions of dollars to publicize their efforts. In this context, death is presented as a positive alternative to pain and suffering, not a utilitarian tool. Proponents of euthanasia also attempt to refute the slippery slope argument in a variety of other ways. They contend that the current mechanisms used by the courts could easily prevent any slide toward involuntary euthanasia,(3) that the current practice of passive euthanasia proves that the slope isnt all that slippery since we havent witnessed any massive killing programs, and that the example of how forced sterilization in the U.S. has diminished rather than increased, provides a more appropriate example to rely on. Even Callahan (1989), a vocal opponent of active euthanasia, admits that the Nazi experience is not particularly applicable to the U.S. experience and that Lives are not b eing shortened. They are steadily being lengthened, and particularly for those who are the most powerless: sick children and the very old, the mentally and mentally retarded, the disabled and the demented (p. 4). Newman (1991) also attacks the concept of the slippery slope itself. Arguing that just pointing out that one type of action could conceivably lead to another constitutes a very unpersuasive argument and that for the premise to hold true, it must be shown that pressure to allow further steps will be so strong that these steps will actually occur. He also reminds us that such arguments are frequently abused in legal and social policy debate (p. 169). Besides Kamisar, the risk of abuse argument has also been put forth by a host of other authors who variously claim that assisted suicides might result in flagrant murders that may be perpetrated by deliberately forcing or coercing self-destruction and that others may advance personal motives by aiding in suicide (Adams, et. al., p. 2031); that when the entire medical profession is involved in euthanasia, including the poorly trained, the insensitive, the less skilled, there becomes the danger that physicians might not do whatever they can to avoid euthanasia if possible (Newman, p. 177); and that some people who enjoy the exercise of power over others might become addicted to the process (Doerflinger, p. 19). It is this fear of abuse that leads the AMAs Council on Ethical and Judicial Affairs to argue that the ban on active euthanasia is a bright line distinction that deters this type of potential abuse. They state: Allowing physicians to perform euthanasia for a limited group of patients who may truly benefit from it will present difficult line-drawing problems for medicine and society. In specific cases it may be hard to distinguish which cases fit the criteria established for euthanasia. For example, if the existence of unbearable pain and suffering was a criterion for euthanasia, the definition of unbea rable pain and suffering could be subject to different interpretations, which might lead to abuse of the process in the case of certain practitioners. (CEJA, p. 2232). Proponents of euthanasia argue that the risk of abuse, while certainly present, is not really much of a threat. This is true first, because laws against homicide are severe enough to provide a strong deterrent (Newman, p. 178); second, because a clear set of guidelines prescribing when active euthanasia is allowed will prevent confusion (Adams, et. al., Gifford); third, because we already risk the practice of abuse by allowing passive euthanasia, and such abuse has not occurred (Newman, p. 178); and finally, that the current state of illegality promotes an absence of discussion and actually encourages the practice of clandestine euthanasia (Newman, p. 177). As Gifford (p. 1572) succinctly puts it, what slope could be more slippery than one with no guardrails whatsoever? Additionally, the balancing tests already in place by the legal system should serve to eliminate this problem. Adams, et. al., (p. 2034) explain: For example, some opponents of physician-assisted suicide argue that pe rmitting some assisted suicides may lead to the killing of patients who want to live. This slippery slope argument expresses a utilitarian rationale for prohibiting suicide assistance. Others argue that suicide and the assistance of suicide is intrinsically evil, and that sanctioning them will damage the fabric of social morality. These and other utilitarian and moral considerations are encompassed within the states interest in preserving the sanctity of all life and affect its weight in the balance against the patients interest in self-determination. Opponents of euthanasia contend that there is no guarantee that euthanasia will be strictly voluntary. The potential for sub

Impact of Globalisation on Australia

Impact of Globalisation on Australia Table of Contents 1. Title page 2. Table of Contents 3. Introduction 3.1 Map of Australia 4. Social Impacts of Globalisation 4.1 Positives 4.2 Negatives 4.3 The Verdict 5. Political Impacts of Globalisation 5.1 Positives 5.2 Negatives 5.3 The Verdict 6. Economic Impacts of Globalisation 6.1 Positives 6.2Negatives 6.3 The Verdict 7. Environmental impacts of Globalisation 7.1 Positives 7.2 Negatives 7.3 The Verdict 8. Conclusion 9. Bibliography Introduction Globalisation is what runs the modern world now especially with the ever-increasing knowledge and advance in technology connecting the world person to person. With modern technology, two people on different sides of the world can talk to each other with instant messaging. In this way the world grows smaller, quicker and easier to live in. It’s not just technology that influenced globalisation, the current ability to have cheap, quick and easy global trade that has given everyone on Earth something not native to their country. As Australia is a fairly new developed country, it is moving away from being a colonised country, globalisation has helped Australia become a wealthier country. Is Globalisation a good thing for Australia? How has Australia been affected and where? This report answers that question. Figure 1: Social Impacts on Australia Australian society has expanded to the entire world with modern technology and networking. Australians can now communicate to people around the world in an instant using instant messaging and phone calls as well as the increasing number of international Australian citizens. However, what effect does this have on Australia? Positives Australia is a fairly new country and often receives information and trade products latest out of most other countries. However, the invention of internet and network has enabled Australians to receive information and retail quicker as well as speak with people worldwide. Australia is close to 3rd world countries and is a fairly cheap source of refuge and international education, this also makes Australia a place for refugees and international families hoping for a good education for their children. Australia is moving closer to the rest of the modern world. Negatives With Australia slowly becoming more culturally and ethnically diverse, unwanted attention is being brought to Australia. The recent G20 meeting has started protests across the wealthier and poorer countries to stop G20 as it may separate the world and throw the economy off balance as well as raising awareness for world crisis and demanding for public needs. The public has also divided to challenge the governments to allow or ban refugees from entering Australia. When Australia allows refugees to enter Australia, people protests as the refugees may bring diseases, spies and war. When Australia sends refugees back then Australians protest to allow refugees in the country. The Verdict Australia has been mainly positively affected by globalisation in society, particularly in the tourist industry. Australia is one of the most unique countries for its strange geographic structure and wildlife. When tourist and refugees that have gained citizenship have seen the country that is Australia, The tourist and refugees will arrange for their friends and family to travel. Political Impacts on Australia Australian government has strong connections with other nations with official visits and assisting with international and worldwide affairs. Recent Australian government has made Australia a very involved country with the world, involving Australia in many world affairs such as wars, political meetings and attending to crises. Positives Involving Australia internationally was the right choice to make a good image other countries. Assisting in wars, attending casual and business meetings as well as just being there for a handshake has given off the image that Australia is a friendly country and a great continent†¦ Negatives Sometimes the Australian government forgets that there is such a thing as too involved. People have died in assisting international wars, several citizens live in fear of war being brought to Australia through involvement and asylum. G20 has scared off some of the poorer countries and some are taking advantage of the meeting and protesting for the world leaders to serve their needs. The Verdict Currently Australia has good favours with wealthier countries but connections with the poorer countries is rusty or unknown due to involvement. However, the country has benefitted from the government’s decisions, connections made and favours from Britain. Australia is also slowly getting wealthier, only a decade ago, people mainly drove cheap but practical Japanese cars but now expensive and better looking European cars are driving around the streets. Economic Impacts on Australia Australia has been isolated from other continents for billions of years and this has allowed Australia to hid it’s valuables until modern technology found them. Australia is rich in iron and coal and as the country itself doesn’t need it, all the raw materials are sold overseas. However, how much is used here and how much is bought from overseas? Positives Australia’s economy is focused on the mining industry and its exports. Australia exports mainly to countries with low iron, coal and gold deposits such as major Asian countries with fast development and requirement for steel. Modern technology has allowed for a year of mining to travel to overseas countries in less than two weeks by boat and about a week by plane factoring in the travel time from mine to port. Being a top exporter for mining products, this makes Australia a favourite for metal exports, most exports going to China, Japan, Korea and the United States. Apart from mining and gas exports Australian farming, medicinal chemicals and animal food products are bought by other countries and combined with all the other top exported products, Australia makes approximately $249 billion from raw materials. Negatives As Australia is a developed country, everyone is trying to stay up to date with the rest of the world and imports computers, machines, parts and cars which are all new, always updating and very expensive. Cars also need fuel to run on so large imports of crude and refined petroleum are bought in plenty as well as medicine for Australia’s sick and injured. Overall, adding all the top imports together, Australia spends about $240 billion on imports, only about $9 billion of profit. The Verdict Australia spends large amounts of money on imports and leaving a little left for saving. Being a young country means Australia doesn’t have a good economic foundation to build on or much variety to offer. To keep up with the world, much has to be imported mostly computers and many different types of machines, all new and expensive. With $249 billion made from exports and $240 billion spent on imports, quite a lot of the products imported are used and not re-sold. Possibly the only time Australia made the most money was during the gold rush and the start of the microchip age. Environmental Impacts on Australia Australia was an originally isolated country where people lived with and not off of the country until European settlement started and the coasts were over taken with modern technology. Was European settlement really beneficial for Australia? Was the old way of living for the indigenous the better way? Which way is better now? Positives In one way, being a young country is good, the Australia is possibly the least polluted and destroyed major European country. Australia is often choosing the most sustainable options for the country as the wildlife and vegetation native is not found anywhere else and currently, introduction of wildlife and vegetation is taking over much of the original land. Negatives Australia is mostly dusty red desert with dry deep-rooted plants, it is also where most of the most plentiful raw mining materials are. Australia is a country that can relate to District 12 of Panem, a country of miners. The desert of Australia is slowly becoming more unstable with the replacement of short-rooted plants, the dust storms of 2009 were caused by the combination of uprooted plants, bushfires, salinity and holes in the country for mining. People experience low visibility, possible blindness, dusty clothes, machines and houses. The dust was dumped all over Eastern Australia and the surrounding seas and coasts. The Verdict Too much has happened to the country that has not helped, the gold rush, introduction of wildlife and vegetation and general European influence from settlement. The way the indigenous Australians lived was a more peaceful and safe than the modern way of life where the more people rip up the land, the better for the people. Soon there would be nothing left for humans to live on and technology won’t be able to feed us. Conclusion Australia has mostly benefited from globalisation in terms of Social and political, however, the economic and environmental aspects are still in between good and bad†¦ Bibliography Cite This For Me, (2014). Cite This For Me: Automatic bibliography generator. [online] Available at: https://www.citethisforme.com/ [Accessed 25 Nov. 2014]. Citewrite.qut.edu.au, (2014). 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